- Inspect and clean the wound, provide local anesthesia for adequate cleansing and debridement of any devitalized structures, assure hemostasis, close the dermis as needed, and assure that surface edges are easily apposable before applying Histoacryl®.
- For wounds at risk for tension, before applying Histoacryl® to the skin surface, provide relief of potential stress along the wound line by approximating wound edges with subcuticular sutures.
- Pull apart or tear the foil pouch to expose the sterile, single patient use ampoule.
- The ampoule is held at its cannula and rigorously shaken downwards to ensure that no adhesive remains within the cannula. Then the ampoule is opened by twisting off the ribbed tip of the cannula. It is advis- able to hold the yellow part of the ampoule between two fingers, holding it vertically with the thin end pointing upward, while opening the ampoule. This will prevent any lost Histoacryl® from escaping from the ampoule when opening.
- To express Histoacryl® from the ampoule tip, apply light pressure to the ampoule.
- Appose tissue edges with forceps and hold in apposition while applying Histoacryl® and for approximately 30 seconds after application to allow Histoacryl® to cure and to prevent seepage between wound edges.
- Apply Histoacryl® to the easily apposed wound edges very sparingly, either as minute drops or as a very thin film along the top edges of the wound. Avoid heavy application.
- After applying Histoacryl®, maintain light pressure along the wound line to maintain apposition for approximately 30 seconds to allow the adhesive to cure.
- After Histoacryl® application is completed; discard the ampoule with any remaining adhesive by putting the ribbed tip over the thin end of the cannula, by placing the ampoule in the foil pouch.
The following information should be shared with the patient:
- If possible, avoid contact with water for the first 24 hours after treatment and minimize contact with
water for an additional 7-10 days. Patients may shower or bathe but allow
only transient wetting of the treatment site. The site should not be scrubbed, soaked or
exposed to prolonged wetness for 7-10 days.
- Do not apply any medications or cream to the wound.
- Do not pull or pick at the wound.
- Avoid extreme physical activity that might dislodge or impact the wound surface.
- Report any discomfort, redness, drainage, swelling or other concerns regarding your wound to your doctor.